The laparoscopic Nissen fundoplication can safely be performed with a low conversion rate and no surgical mortality in neurologically normal and neurologically impaired children. Neurologically impaired children are more susceptible to per- and postoperative complications. A good quality of life and a high index of satisfaction could be achieved in most patients.
A traumatic lesion of the axillary artery after a proximal humeral fracture is very uncommon. The clinical presentation can be very misleading and therefore it is mandatory to have a high index of suspicion and, as presented in this case report, to check the pulsations in different positions. Open repair remains the golden standard for most surgeons, but, in selected cases, an endovascular approach is feasible. The functional outcome is mostly determined by the associated trauma, especially the injury to the nervous structures.
Mesenteric lymphangioma can cause an acute abdomen in children. Complete resection is recommended but might not be feasible without compromising the functional digestive outcome. Alternative treatments should be studied further to treat diffuse and complicated ML.
A total of 740 midbrain, thalamic, and hypothalamic neurons were tested as to their distribution and response/stimulus characteristics by means of thermal stimulation of the scrotal skin. The most frequent response type exhibited a basic discharge rate up to a threshold temperature and then switched to a maximum firing rate. The inverse behaviour was found in a low proportion. The temperature range in which the neurons switch from the 'low' to the 'high' state has been called the 'operating range' of the neuron. This study reveals, in contrast to former studies, that the 'operating range' is extremely narrow. This holds both for the individual neuron and for the populations studied. It is confirmed by simultaneous recordings and by cross correlation analysis that there is only one temperature threshold for all warm responsive neurons involved. It is concluded that according to the mean firing rate, temperature may only be discriminated as to below or above threshold. This means that a binary information is transmitted. For continuous temperature sensation and regulation either further neuronal types disposing of a continuous temperature/frequency characteristic or additional coding mechanisms have to be assumed. The major task of the switching neurons, integrating information from all over the body should be the generation of a trigger signal for warm defence.
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